Wide-Field Imaging and Angiography

The recently developed wide-field imaging systems (WIS) enable 200 degrees imaging of retina by just one shot and angiographic and autofluorescence imaging of retinal periphery. In addition to facilitating the detection of retinal pathologies, WIS revealed the importance of lesions in retinal periphery and peripheral non-perfusion areas invisible by standard angiography. The novel finding of utmost importance for diabetic retinopathy (DR) patients was the 3 fold increased risk of progression assessed for peripheral DR lesions compared to that in posterior pole. Detection of peripheral non-perfusion areas in DR or retinal vein occlusion cases with refractory macular edema altered the management approach. On the other hand by means of WIS new terms have been brought into the era like “peripheral vascular leakage” whose relevance and importance is unknown for retinal vascular diseases. In age related macular degeneration, a disease known to affect the macula, WIS proved the effect on peripheral retina documented by both angiography and also peripheral autofluorescence. WIS further contributes for the detection of additional pathologies in diseases known to affect the peripheral retina like uveitis, degenerative myopia etc. WIS that enabled documentation of retinal periphery and thus seems to change the treatment modality and probably clinical classification of unknown or treatment refractory pathologies in retinal diseases where we mainly focused to macula always.